Very little is known about the impact of dementia on American Indians, despite dramatic increases over the past 50 years in this population's life expectancy. The goal of this Mentored Career Development Award (K01) is to provide the applicant with the skills and knowledge necessary to develop an independent program of research in the area of the evaluation and management of dementia among American Indians. As such, this proposal has three specific career development goals: 1) to better understand the cultural expression and management of dementia as it is experienced in Native communities, 2) to develop proficiency in the detection and assessment of dementia among Native elders, and 3) to cultivate expertise in the area of informal care giving for American Indians with dementia. The research project associated with this career development award constitutes a seminal effort to investigate dementia in a Native community. Specifically, the aims of this research are 1) to explore the cultural phenomenology of cognitive impairment within an American Indian community, 2) to test the acceptability and validity of a culturally modified dementia evaluation among Native elders, and 3) to examine family caregiving for persons with dementia, both its burdens and gratifications. To accomplish these aims, interviews will be conducted with 150 elderly clients of a senior nutrition program on a Northern Plains reservation. These interviews include a culturally modified dementia evaluation, as well as open-ended questions that explore the experience of aging, impairment, and being cared for in a reservation community. In addition, 30 family caregivers to elders representing a range of scores on the dementia evaluation will be interviewed about the challenges and gratifications of providing care to disabled elders. This research will yield valuable information about the cultural formulation, expression, and management of dementia in a Native community, knowledge that is crucial to efforts to determine dementia prevalence and to develop services for cognitively impaired Native elders and their family caregivers.